Résumé
Currently, in developing countries, parasitic and bacterial diseases as amebiasis, giardiasis, trichonomiasis, leishmaniasis, trypanosomiasis, tuberculosis, and nocardiasis are a public health problem. The pharmacological treatment for these diseases is not completely effective and causes several side effects in patients. Therefore, the search for new compounds with biological activity is very important to develop new drugs safely and more efficiently. In this study, different organic extracts obtained from thirty-seven species of the Salvadoran flora were evaluated in several in vitro models to determine their potential activity against five protozoa (Entamoeba histolytica, Giardia lamblia, Trichomonas vaginalis, Leishmania mexicana, and Trypanosoma cruzi) and three bacteria (Acinetobacter baumanni, Mycobacterium tuberculosis, and Nocardia brasiliensis). The results showed the activity of eight extracts with IC50values of less than 100 µg/mL against L. mexicanaand five extracts with MICs values less than <50 µg/mL against M. tuberculosis. Besides, seven plant species showed MICs ≤3.125 µg/mL against N. brasiliensis. Additionally, secondary metabolites (flavonoids and monoterpene oxygenate) previously reported as active were fingerprint by UPLC-MS to establish a potential correlation with the biological activity showed.
Actualmente, en los países en vías de desarrollo, enfermedades parasitarias y bacterianas como la amebiasis, giardiasis, trichonomiasis, leishmaniasis, tripanosomiasis, tuberculosis y nocardiasis son un problema de salud pública. El tratamiento farmacológico de estas enfermedades no es del todo eficaz y provoca varios efectos secundarios en los pacientes. Por lo tanto, la búsqueda de nuevos compuestos con actividad biológica es muy importante para desarrollar nuevos fármacos, seguros y eficaces. En este estudio se evaluaron diferentes extractos orgánicos obtenidos de treinta y siete especies de la flora salvadoreña en varios modelos in vitro para determinar su actividad potencial contra cinco parásitos (Entamoeba histolytica, Giardia lamblia, Trichomonas vaginalis, Leishmania mexicana y Trypanosoma cruzi) y tres bacterias (Acinetobacter baumanni, Mycobacterium tuberculosis y Nocardia brasiliensis). Los resultados mostraron la actividad de ocho extractos con valores de CI50 menores a 100 µg/mL contra L. mexicana y cinco extractos con valores de CIMs <50 µg/mL contra M. tuberculosis. Además, siete especies de plantas presentaron CIM ≤3,125 µg/mL frente a N. brasilienses. Finalmente, los metabolitos secundarios (flavonoides y monoterpenos oxigenados) previamente reportados como activos fueron determinados por UPLC-MS para establecer una posible correlación con la actividad biológica mostrada.
Sujets)
Extraits de plantes/pharmacologie , Flore , Antibactériens/usage thérapeutique , Antiparasitaires/usage thérapeutique , Plantes médicinales , Maladies transmissibles/traitement médicamenteux , SalvadorRésumé
We report a clinical case from a patient with alcoholic cirrhosis who had chronic anemia and carried out several endoscopic studies without evidence of active bleeding, a complementary study with endoscopic capsule was requested to search for a source of bleeding. In the analysis of laboratory data, the presence of hypereosinophilia stands out in parallel. The images obtained in the video capsule study show geoparasites helminth-type. After parasite treatment, anemia improves and the absolute eosinophil count is normalized.
Reportamos el caso de un paciente cirrótico por alcohol con anemia crónica quien se realizó varios estudios endoscópicos sin evidencia de sangrado activo, por tal motivo se solicitó estudio complementario con cápsula endoscópica para búsqueda de fuente de sangrado. En el análisis de los datos de laboratorio paralelamente destaca la presencia de hipereosinofilia. Las imágenes obtenidas en el estudio de la video cápsula muestran varios geoparásitos de tipo helmintos. Posterior al tratamiento antiparasitario mejora la anemia y se normaliza el recuento absoluto de eosinófilos.
Sujets)
Humains , Mâle , Adulte d'âge moyen , Endoscopie par capsule , Hémorragie gastro-intestinale/étiologie , Parasitoses intestinales/diagnostic , Éosinophilie/étiologie , Hémorragie gastro-intestinale/diagnostic , Anémie/étiologie , Parasitoses intestinales/complications , Parasitoses intestinales/traitement médicamenteux , Intestins/parasitologie , Cirrhose du foie/complications , Antiparasitaires/usage thérapeutiqueRésumé
La dermatosis denominada larva migrans cutánea: (LMC) es una infección cutánea secundaria a infestación parasitaria por la migración de larvas de anquilostomas animales a la epidermis humana, frecuentemente por contacto directo con suelos contaminados, especialmente en zonas tropicales. Se caracteriza por la aparición de lesiones induradas, eritematosas con patrón irregular o serpiginoso acompañado de prurito. Describimos un caso de LMC en una niña, adquirido durante unas vacaciones en Colombia y tratado inicialmente como celulitis con antibióticos (AU)
Cutaneous larva migrans (CLM) is an infection secondary to parasitic infestation due to the migration of animal hookworm larvae into the human skin, frequently by direct contact with contaminated grounds, especially in the tropics. Clinically, it is characterized by the appearance of indurated, erythematous lesions with irregular or "creeping eruption" pattern and pruritus. This article describes a case of CLM infection in a pediatric patient, it was acquired during the holidays in Colombia, diagnosed as cellulitis and treated accordingly with antibiotics without success (AU)
Sujets)
Humains , Femelle , Enfant d'âge préscolaire , Larva migrans/diagnostic , Cellulite/diagnostic , Dermatoses de la main/diagnostic , Ivermectine/usage thérapeutique , Larva migrans/traitement médicamenteux , Céfalexine/usage thérapeutique , Anti-inflammatoires non stéroïdiens/usage thérapeutique , Ibuprofène/usage thérapeutique , Diagnostic différentiel , Cellulite/traitement médicamenteux , Dermatoses de la main/traitement médicamenteux , Antibactériens/usage thérapeutique , Antiparasitaires/usage thérapeutiqueRésumé
Abstract The present work aims to investigate the antiparasitic and the immunomodulating effects of nitazoxanide (NTZ) and ivermectin (IVC) alone or combined together or combined with selenium (Se), on Cryptosporidium infection in diabetic mice. The results revealed that the combined NTZ and IVC therapy achieved the highest reduction of fecal oocysts (92%), whereas single NTZ showed the lowest reduction (63%). Also, adding Se to either NTZ or IVC resulted in elevation of oocyst reduction from 63% to 71% and from 82% to 84% respectively. All treatment regimens, with the exception of NTZ monotherapy, showed a significant improvement in the intestinal histopathology, the highest score was in combined NTZ and IVC therapy. The unique results of immunohistochemistry in this study showed reversal of the normal CD4/CD8 T cell ratio in the infected untreated mice, however, following therapy it reverts back to a normal balanced ratio. The combined (NTZ+ IVC) treatment demonstrated the highest level of CD4 T cell expression. Taken together, NTZ and IVC combined therapy showed remarkable anti-parasitic and immunostimulatory effects, specifically towards the CD4 population that seem to be promising in controlling cryptosporidiosis in diabetic individuals. Further research is required to explore other effective treatment strategies for those comorbid patients.
Resumo O presente trabalho tem como objetivo investigar os efeitos anti-parasitários e imunomodulantes da nitazoxanida (NTZ) e ivermectina (IVC), isoladas ou em associação, e do selênio (SE), associado à NTZ ou à IVC, sobre a infecção por Cryptosporidium em camundongos diabéticos. Os resultados revelaram que a terapia combinada com NTZ e IVC resultou em maior redução de oocistos fecais, enquanto a NTZ isolada mostrou a menor redução de oocistos fecais (63%). Além disso, a associação do SE com a NTZ ou IVC resultou em redução do número de oocistos fecais de 63% para 71% e de 82% para 84%, respectivamente. Todos os tratamentos, com exceção da monoterapia com NTZ, mostraram uma melhora significativa nos índices relacionados à histopatologia intestinal. Os resultados da imuno-histoquímica mostraram reversão da razão celular CD4/CD8 T normal nos camundongos infectados não tratados, no entanto, após a terapia, houve retorno à razão celular CD4/CD8 T normal. O tratamento combinado (NTZ+ IVC) demonstrou o mais alto nível de expressão celular CD4 T. Em conclusão, a terapia combinada com NTZ e IVC mostrou efeitos anti-parasitários e imunoestimuladores notáveis, especificamente para a população CD4, que parecem ser promissores para o controle da criptosporidiose em indivíduos diabéticos.
Sujets)
Animaux , Lapins , Maladies des rongeurs , Sélénium/usage thérapeutique , Cryptosporidiose/traitement médicamenteux , Cryptosporidium , Diabète expérimental/traitement médicamenteux , Thiazoles , Ivermectine/usage thérapeutique , Composés nitrés , Antiparasitaires/usage thérapeutiqueRésumé
Devido aos altos índices de resistência dos parasitas aos diferentes princípios ativos comerciais, novas alternativas de controle vêm sendo estudadas, entre elas a fitoterapia. Essas medidas visam a busca de métodos auxiliares no controle das parasitoses, entretanto, muitos produtos estão disponíveis no mercado e não têm comprovação científica de sua eficácia ou de possíveis efeitos colaterais. O objetivo deste estudo foi avaliar os efeitos hematológicos e hepáticos após a administração de torta de Neem (Azadirachta indica) em ovinos. Foram testadas três dosagens da torta de Neem adicionada ao sal mineral (1, 2 e 4%), administradas por 126 dias para 32 ovinos da raça Lacaune, divididos em quatro grupos sendo três grupos para os diferentes tratamentos e um controle, o qual recebeu somente sal mineral. Amostras de sangue foram colhidas a cada 21 dias para realização do hemograma completo, dosagem de proteína plasmática total e fibrinogênio e avaliação da bioquímica clínica hepática. Nestas mesmas ocasiões, amostras de fezes foram coletadas para a quantificação de ovos por grama de fezes (OPG). Foram observadas diferenças estatísticas entre momentos e grupos para diversas variáveis, porém sem estarem relacionadas à administração de torta de Neem. Os resultados obtidos de hemograma completo, dosagem de proteína plasmática total, fibrinogênio e de bioquímica clínica hepática indicaram que a administração de torta de Neem nas concentrações de 1, 2 e 4%, não interfere nos valores hematológicos, nem sobre a integridade e função hepática de ovinos da raça Lacaune.
Due to high levels of parasite resistance to different commercial active ingredients, new control alternatives are being studied, including the phytotherapy. These measures aim to search for auxiliary methods in the control of parasitic diseases. However, there are many products available in the market and there are no scientific proof of its efficacy. The objective of this study was to evaluate the hematological and hepatic effects following administration of Neem pie (Azadirachta indica) in sheep. Three concentrations of Neem cake was added to the mineral salt (1, 2 and 4%) and administered during 126 days to 32 Lacaune breed sheeps, divided into four groups: three groups for different treatments and a and a control were tested, the ladder receiving only mineral salt. Blood samples were taken every 21 days to perform the complete blood count, serum total plasma protein and fibrinogen and liver biochemical evaluation. In those same times, fecal samples were collected for quantification of eggs per gram of feces (EPG). Statistical differences between times and groups for several variables were observed, but without being related to the administration of Neem pie. The results of complete blood count, measurement of total plasma protein, fibrinogen and hepatic clinical biochemistry indicated that administration of Neem pie at concentrations of 1, 2 and 4%, does not interfere in hematological values, or on the integrity and liver function Lacaune sheep breed.
Sujets)
Animaux , Numération des oeufs de parasites/médecine vétérinaire , Hémogramme/médecine vétérinaire , Ovis/sang , Protéines du sang/analyse , Médicaments Phytothérapeutiques , Tests hématologiques/médecine vétérinaire , Tests de la fonction hépatique/médecine vétérinaire , Antiparasitaires/usage thérapeutiqueRésumé
La infección por Trypanosoma cruzi está garantizada por la presencia del parásito en muchos géneros animales incluido el hombre. Este a su vez, no solo adquiere el parásitoa través del vector (cutánea, por mucosas, oral) o por secreciones de didelfidos o accidentalmente por manipulación de material biológico infectante,sino también por la trasmisión hombre-hombre la cual aumenta la diseminación de la Enfermedad de Chagas aunque en menor proporción (trasmisión congénita, transfusional o por trasplante de tejidos). El parásito alcanza al feto in utero principalmente por su capacidad de atravesar la placenta especialmente después de la semana 20 cuando la barrera placentaria se adelgaza progresivamente. Sin embargo solo del 1 al 10% de los niños nacidos de madres con Enfermedad de Chagas desarrollan infección aguda variando de acuerdo al país, edad gestacional, al genotipo y carga del parásito entre varios factores. La clínica del neonato con T. cruzi va desde casos asintomáticos, bajo peso, prematuridad, hepatoesplenomegalia, dificultad respiratoria,hastael desenlace fatal. La prevención se basa en la detección por serología y tratamiento oportuno en niñas y mujeres antes del embarazo ya que los antiparasitarios específicos producen efectos adversos y en principio están contraindicados durante el embarazo. En cambio el tratamiento está indicado en el niño en cualquier momento cuando se demuestre la patología. El despistaje de la infección por T. cruzi debería ser obligatorio en toda Latinoamérica y en toda mujer latinoamericana en el mundo a fin de estar preparado para la atención postparto al infante y a la madre(AU)
Infection with Trypanosoma cruzi is guaranteed by the presence of the parasite in many animal genera including man. This in turn, not only acquires the parasite by contact with a vector (skin, mucoses and oral transmission) or by secretions of didelfides or accidentally by manipulation of infecting biological material, but also by man-man transmission which increases the spread of Chagas disease (congenital, transfusion or tissue transplant transmission). The parasite reaches the fetus in utero mainly due to its ability to cross the placenta especially after week 20 when the placental barrier becomes progressively thinner. However, only 1 to 10% of children born from mothers with Chagas disease develop acute infection, varying according to country, gestational age, genotype, and parasite load among various factors. The clinic of the neonate with T. cruzi ranges from asymptomatic cases, low weight, prematurity, hepatosplenomegaly, respiratory distress to the fatal outcome. Prevention is based on the detection by serology and timely treatment in girls and women before pregnancy since specific antiparasitic drugs produce adverse effects and are in principle contraindicated during pregnancy. Instead, treatment is indicated in the child at any time when the pathology is demonstrated. The screening of T. cruzi infection should be mandatory in all Latin America and in all Latin American women in the world in order to be prepared for the postpartum care of the infant and the mother(AU)
Sujets)
Humains , Femelle , Grossesse , Maladie de Chagas/prévention et contrôle , Maladie de Chagas/épidémiologie , Transmission verticale de maladie infectieuse/prévention et contrôle , Prise en charge postnatale , Venezuela/épidémiologie , Études séroépidémiologiques , Antiparasitaires/usage thérapeutiqueRésumé
CONTEXTO: A COVID-19 é uma pandemia de risco muito alto a nível global pela OMS. Até o momento não existem terapias específicas, embora diferentes tratamentos estejam em investigação. Mais recentemente, tem havido crescente interesse no uso da nitazoxanida no tratamento de COVID-19, dada sua atividade antiviral de amplo espectro. OBJETIVOS: Identificar, avaliar sistematicamente e sumarizar as melhores evidências científicas disponíveis sobre a eficácia e a segurança da nitazoxanida para COVID-19. MÉTODOS: Revisão sistemática rápida (rapid review methodology). RESULTADOS: Após o processo de seleção, foram avaliados cinco estudos clínicos em andamento. CONCLUSÃO: Cinco estudos com o objetivo de avaliar a eficácia e segurança da nitazoxanida no tratamento de COVID-19 estão em andamento. Devido à ausência de evidência sobre o uso deste medicamento para o tratamento de infecções por coronavírus que causem infecções respiratórias, não é possível recomendar seu uso como terapia para COVID-19.(AU)
Sujets)
Humains , Infections à coronavirus/traitement médicamenteux , Antiparasitaires/usage thérapeutique , Évaluation de la technologie biomédicale , Analyse Coût-EfficacitéRésumé
Miasis es la infestación de humanos y animales por larvas de dípteros ciclorrafos con invasión y destrucción tisular. Cochliomyia hominivorax es responsable del 80% de las miasis en la Argentina. Es importante realizar el diagnóstico etiológico específico debido a la agresividad de las larvas de esta especie, las que pueden provocar cuadros clínicos graves. Presentamos cuatro casos de miasis por C. hominivorax. Dos de los pacientes residían en la ciudad de Buenos Aires y trabajan en zona rural, y los otros dos residían en el Gran Buenos Aires.
Miasis is the infestation of man and animals by larvae of flies belonging to the order Diptera, suborder Cyclorrapha. Eighty percent of miasis in Argentina is caused by Cochliomyia hominivorax, a species that induces pronounced tissue invasion and destruction, and results in severe clinical forms. Because of the aggressiveness of its larvae, it is important to reach a specific etiological diagnosis. We present four cases of miasis by C. hominivorax in two patients living in the city of Buenos Aires but working in a rural area and two patients living in the Greater Buenos Aires.
Sujets)
Humains , Animaux , Mâle , Femelle , Adulte d'âge moyen , Sujet âgé , Myiases/parasitologie , Argentine , Ivermectine/usage thérapeutique , Anatoxine tétanique/usage thérapeutique , Diptera , Larve , Antibactériens/classification , Antibactériens/usage thérapeutique , Myiases/étiologie , Myiases/traitement médicamenteux , Antiparasitaires/usage thérapeutiqueRésumé
Resumen Se comunica el caso clínico de un varón, con antecedentes de una cirrosis hepática alcohólica y gota, usuario crónico de antiinflamatorios, incluyendo corticoesteroides. Consultó por una melena secundaria a una úlcera bulbar. Durante su internación presentó fiebre, tratándose con ceftriaxona por un probable foco urinario. Por persistir febril, se realizó una paracentesis diagnóstica. En la muestra de líquido ascítico se observaron larvas de Strongyloides stercoralis. Recibió tratamiento antiparasitario con ivermectina, con buena respuesta clínica. Aunque la infección por S. stercoralis es relativamente frecuente en pacientes con cirrosis hepática alcohólica, la ascitis infectada por Strongyloides corresponde a una forma de presentación infrecuente. Este caso muestra la importancia de la paracentesis diagnóstica en todo paciente con ascitis secundaria a una cirrosis. Es importante considerar la presentación atípica de la infestación por Strongyloides en el contexto del paciente inmunocomprometido, ya que sin tratamiento puede tener una alta mortalidad.
Abstract Male patient, with a history of alcoholic cirrhosis frequent user of anti-inflammatory drugs including corticosteroids. He consulted for digestive bleeding secondary to a bulbar ulcer. During the admission, he had fever and antibiotic treatment with ceftriaxone is started, for a urinary infection. Fever persisted for 48 hours, so a diagnostic paracentesis was made: Strongyloides stercoralis larvae were seen in the direct microscopic exam. The patient started antiparasitic treatment with ivermectin. He was discharged and did not returned for follow up. Although infection with S. stercoralis is relatively common in patients with alcoholic liver cirrhosis, ascites infected with Strongyloides corresponds to an infrequent form of presentation. This case shows the importance of diagnostic paracentesis in every cirrhotic patient. It is important to consider atypical presentation of Strongyloides infection in the immunocompromised host, considering it could be fatal without treatment.
Sujets)
Humains , Animaux , Mâle , Strongyloïdose/complications , Strongyloïdose/physiopathologie , Strongyloïdose/traitement médicamenteux , Strongyloides stercoralis/isolement et purification , Cirrhose du foie/étiologie , Cirrhose du foie/parasitologie , Cirrhose du foie/traitement médicamenteux , Ascites/parasitologie , Ivermectine/usage thérapeutique , Liquide d'ascite/parasitologie , Résultat thérapeutique , Antiparasitaires/usage thérapeutiqueRésumé
As informações vindas de outras nações já evidenciavam que, quando a covid-19 chegasse ao Brasil, grandes desafios seriam enfrentados. Como estratégia de resposta aos pares, o Cremesp deu início às aulas virtuais no assunto, em um momento em que as lives ainda nem estavam tão popularizadas, além de produzir textos em seus veículos tradicionais e novo hotsite específico. O material ficou tão completo que deu origem a esta publicação, disponibilizada para download, para que os colegs possam imprimir e ter como material de apoio fácil, no momento em que estiverem em seus consultórios e plantões nos hospitais, sem a necessidade de consultar o smartfone, tablet ou computador. A publicação claro é inacabada, pois dados sobre Sars-CoV-2 surgem e mudam a todo o momento com novos estudos.
Sujets)
Humains , Équipement de protection individuelle/effets indésirables , Dépistage sérologique de la COVID-19 , SARS-CoV-2/immunologie , COVID-19/prévention et contrôle , Traitements médicamenteux de la COVID-19 , Soins palliatifs , Ventilation artificielle , Maladies de la peau , Ivermectine/usage thérapeutique , Brésil/épidémiologie , Chloroquine/usage thérapeutique , Lopinavir/usage thérapeutique , COVID-19/psychologie , Anticorps monoclonaux/usage thérapeutique , Antiparasitaires/usage thérapeutiqueRésumé
Se expone el caso de una paciente obesa inmunodeprimida que presentó una sarna costrosa. Luego de la sospecha clínica se confirmó el diagnóstico mediante acarotest. La paciente sufrió algunas complicaciones asociadas a su condición general, como sobreinfección de sus lesiones cutáneas, epistaxis e insuficiencia renal aguda, que fueron tratadas. La sarna costrosa fue tratada con ivermectina oral con dosis de 15 mg (200 ug/kilo de peso ideal según la talla), los días 1, 2, 7, 8 y 15, obteniendo una excelente respuesta terapéutica.
We present the case of an immunosuppressed obese patient who presented with crusted scabies. After clinical suspicion, the diagnosis was confirmed with skin scraping for the diagnosis of scabies. The patient presented some complications associated with her baseline condition, such as superinfection of her skin lesions, epistaxis and acute renal failure, which were treated. Crusted scabies was treated with oral ivermectin with a dose of 15 mg (200 ug/kg of ideal weight according to height), on days 1,2,7,8 and 15, obtaining an excellent therapeutic response.
Sujets)
Humains , Femelle , Adulte d'âge moyen , Gale/traitement médicamenteux , Ivermectine/administration et posologie , Antiparasitaires/administration et posologie , Ivermectine/usage thérapeutique , Administration par voie orale , Antiparasitaires/usage thérapeutiqueRésumé
ABSTRACT Background: Studies related to infectivity status of insect vectors are seen as necessities in understanding the epidemiology of vector-borne diseases and planning effective control measures. This study assessed the infectivity ofSimulium damnosum s.l. around Owena River as well as evaluated therapeutic coverage of Ivermectin distribution in the area. Method: Human landing sampling method was used to collect adult flies on human attractants from 07:00 to 18:00 for two consecutive days a month for three months (July 2016 - September 2016). Parity assessment was conducted to determine the age of fly populations. Parous flies were further dissected to detect the presence or absence ofOnchocerca larvae. Biting rates and transmission potentials were calculated using standard methods. A quantitative survey was carried out to determine the therapeutic coverage and compliance to ivermectin treatment for the control of Onchocerciasis in the study area using standard household coverage questionnaires. Results: A total of 914 adult female flies were collected during the study period. The daily biting rate (DBR) varied from 146 fly per man day (FMD) in July to 162.5 FMD in August. The monthly biting rate (MBR) was lowest in September (2170 bites per man per month) but highest in August (3358.3 bites per man per month). MBD ranged from 13.23 fly per man hour (FMH) in July to 14.77 FMH in August. The results indicated that the majority of the flies collected at the sampling points were nulliparous [685 (74.95%)] while others were parous [229 (25.05%)]. The biting activity of the flies showed a marked decrease in population in August compared to July which later increased in September. Infection rates varied from 2 (0.7%) in July to 7 (2.2%) in August while the infectivity rate during the study ranged from zero (July and September) to 3 (1.0%) in August. Conclusion: Despite the years of treatment of onchocerciasis in Owena community, there were still some infective flies capable of transmitting O. volvolus. This could be due to the low rate of therapeutic coverage as a result of non-compliance in the community for various reasons earlier stated.
Sujets)
Humains , Animaux , Mâle , Femelle , Enfant d'âge préscolaire , Enfant , Adolescent , Adulte , Adulte d'âge moyen , Sujet âgé , Jeune adulte , Onchocercose/traitement médicamenteux , Onchocercose/transmission , Simuliidae/parasitologie , Ivermectine/usage thérapeutique , Morsures et piqûres d'insectes/traitement médicamenteux , Antiparasitaires/usage thérapeutique , Onchocercose/parasitologie , Rivières , Morsures et piqûres d'insectes/parasitologie , Morsures et piqûres d'insectes/épidémiologie , Vecteurs insectes/parasitologie , Nigeria/épidémiologieRésumé
We present a case of a female adolescent with severe acute Chagas myocarditis, acquired by oral transmission in an endemic area in the Brazilian western Amazon, who had electrocardiographic changes normalized after empirical treatment with the antiparasitic drug benznidazole combined with conventional treatment for severe heart failure
Sujets)
Humains , Femelle , Enfant , Cardiomyopathie associée à la maladie de Chagas , Maladie de Chagas/épidémiologie , Électrocardiographie/méthodes , Débit systolique , Trypanosoma cruzi , Échocardiographie/méthodes , Défaillance cardiaque , Antiparasitaires/usage thérapeutiqueRésumé
Resumen La infección por Strongyloides stercoralis es una parasitosis frecuente en las regiones tropicales y subtropicales, incluyendo la Amazonía peruana. En pacientes con inmunocompromiso, las manifestaciones clínicas son variadas y es frecuente la diseminación sistémica de la enfermedad, con compromiso de diversos órganos. Las manifestaciones cutáneas son infrecuentes y se describen en pacientes con algún grado de inmunosupresión. Se presenta el caso de un paciente inmunocompetente que desarrolló una púrpura reactiva por una infección por Strongyloides stercoralis crónica. Ante ello, es posible el compromiso cutáneo en pacientes inmunocompetentes con reagudización sistémica por este parásito.
Infection with Strongyloides stercoralis is a common parasitic infection in tropical and subtropical regions, including the Peruvian Amazon. The clinical manifestations are varied in patients with immunocompromised disease, and the systemic spread of the disease is frequent, compromising different organs and systems. Cutaneous manifestations are infrequent, being described in patients with some degree of immunosuppression. We present the case of an immunocompetent patient who developed a reactive purpura due to chronic Strongyloides stercoralis infection. Thus, skin involvement is possible in immunocompetent patients with systemic exacerbation due to this parasite.
Sujets)
Humains , Animaux , Mâle , Adulte , Jeune adulte , Purpura/étiologie , Purpura/immunologie , Strongyloïdose/complications , Strongyloïdose/immunologie , Purpura/traitement médicamenteux , Ivermectine/usage thérapeutique , Chlorphénamine/usage thérapeutique , Sujet immunodéprimé , Strongyloides stercoralis/isolement et purification , Antiparasitaires/classification , Antiparasitaires/usage thérapeutique , Antiprurigineux/usage thérapeutiqueRésumé
Abstract: Crusted scabies is a less common variant of scabies that is highly contagious, difficult to treat and involves infestation by Sarcoptes scabiei var. hominis. The classical clinical presentation includes crusted, scaly and generally non-pruritic lesions usually located on the head, neck, palmar, plantar and periungual region. It was first described in Norway in 1848 in patients with leprosy who presented with crusted lesions. In this study, we report the case of a patient with crusted scabies with florid clinical manifestations and chronic liver disease due to hepatitis B and delta virus infection.
Sujets)
Humains , Mâle , Adulte d'âge moyen , Gale/anatomopathologie , Gale/traitement médicamenteux , Virus de l'hépatite delta , Virus de l'hépatite B , Maladie du foie en phase terminale/virologie , Gale/immunologie , Résultat thérapeutique , Maladie du foie en phase terminale/complications , Antiparasitaires/usage thérapeutiqueRésumé
Amebiasis is the infection by Entamoeba histolytica, a protozoan capable of invading the colonic mucosa causing a diarrheic syndrome, although most of the time is mild, it can lead to a fulminating colitis. Sometimes it can spread to other organs; among extra-intestinal manifestations of this parasite, the most frequent is the amebic liver abscess. In the next pages, general aspects of this protozoan, its epidemiology, clinical findings, diagnosis and treatment are reviewed, emphasizing the possibilities of diagnosis and treatment available in Chile.
La amebiasis corresponde a la infección por Entamoeba histolytica, protozoo capaz de invadir la mucosa del colon provocando un cuadro diarréico que, si bien la mayoría de las veces es leve, puede llegar a una colitis fulminante. En algunas oportunidades puede diseminarse a otros órganos; dentro de las manifestaciones extra-intestinales de este parásito, la más frecuente es el absceso hepático amebiano. A continuación se revisan aspectos generales de este protozoo, su epidemiología, cuadro clínico, diagnóstico y tratamiento, destacando las posibilidades de diagnóstico y tratamiento disponibles en Chile.
Sujets)
Humains , Dysenterie amibienne/diagnostic , Dysenterie amibienne/traitement médicamenteux , Abcès amibien du foie/diagnostic , Abcès amibien du foie/traitement médicamenteux , Diarrhée/parasitologie , Dysenterie amibienne/parasitologie , Entamoeba histolytica/pathogénicité , Abcès amibien du foie/parasitologie , Métronidazole/usage thérapeutique , Antiparasitaires/usage thérapeutiqueRésumé
O objetivo do presente trabalho foi relatar a eficácia do fluralaner no tratamento da demodicidose juvenil generalizada canina. Dois caninos, apresentando dois e três meses de idade, com diagnóstico clínico e parasitológico de demodicidose generalizada, foram tratados com administração única de fluralaner, na dose recomendada em bula pelo fabricante. Além disso, foi realizada a terapia adjuvante à base de xampu de peróxido de benzoíla e domperidona. Observou-se uma resposta terapêutica satisfatória, com repilação completa ao 30º dia após a administração do fármaco. Para cada paciente, foi realizado exame parasitológico do raspado cutâneo aos 75 e 90 dias seguintes ao início do tratamento, e todos foram negativos. Tendo em vista a elevada eficácia do tratamento proposto, sugere-se a inclusão do fluralaner nos protocolos terapêuticos destinados à demodicidose canina, particularmente nos pacientes pediátricos e com a forma generalizada da doença.(AU)
The aim of the present study was to report the efficiency of fluralaner on the treatment of two cases of canine generalized juvenile demodicosis. Two puppies, aging two and three months old, with the clinic and parasitological diagnosis of generalized demodicosis were treated with single administration of fluralaner. according to the dose recommended by the responsible laboratory. Additionally, adjuvant therapy was applied using benzoyl peroxide shampoo and domperidone. A satisfactory therapeutic response was observed, and complete repilation was present at the 30th day after drug administration. For each patient, at the 75th and 90th day after the treatment began, skin scrapings were performed in order to investigate the presence of Demodex sp; and all were negative. Considering the high efficiency of the treatment used, we suggest the inclusion of fluralaner on the therapeutic protocol for canine demodicosis, particularly in pediatric patients and with the generalized form of the disease.(AU)
Sujets)
Animaux , Chiens , Antiparasitaires/usage thérapeutique , Peroxyde de benzoyle/usage thérapeutique , Dompéridone/usage thérapeutique , Dermatoses parasitaires/traitement médicamenteux , Dermatoses parasitaires/médecine vétérinaireRésumé
The strongyloidiasis is a parasitic disease that poses as a serious public health problem, mainly in tropical and subtropical countries. Over the years, some conditions, such as advances in corticosteroid treatment and immunosuppressive diseases, have improved not only the increase in cases of strongyloidiasis, but also the emergence of severe forms of the disease and / or deaths. For these reasons, the objective of this study is to make a critical analysis of the occurrence of strongyloidiasis in patients with comorbidities, describing clinical and epidemiological characteristics associated with these diseases that can highlight the importance of monitoring this parasitosis in most susceptible groups.
La estrongiloidiasis es una parasitosis que representa un grave problema de salud pública, principalmente en países ubicados en regiones tropicales y subtropicales. A lo largo de los años, algunas condiciones, como por ejemplo, avances en el tratamiento con corticosteroides y enfermedades que evolucionan con inmunosupresión, han favorecido no solamente al aumento de casos de estrongiloidiasis, sino también al surgimiento de formas graves de la enfermedad y/u decesos. Por lo expuesto, el objetivo del presente estudio fue realizar un análisis crítico de la ocurrencia de la estrongiloidiasis en portadores de co-morbilidades, describiendo las características clínico-epidemiológicas de esa asociación que puedan resaltar la importancia de vigilar esta parasitosis en grupos considerados más susceptibles.